PECULIARITIES OF HEMODYNAMICS IN PREGNANT WOMEN WITH BRONCHIAL ASTHMA

Abstract

Bronchial asthma (BA) is a global health problem worldwide. The aim of the work was to determine the clinical and functional characteristics of bronchial asthma during pregnancy in comparison with indicators of intracardiac, renal hemodynamics state and newborn health state. We analyzed the clinical and functional characteristics of the asthma course, pregnancy outcomes, childbirths and newborns status in 66 patients with asthma. There were used clinical and anamnesis data, integrated monitoring of clinical syndromes, right heart diastolic function estimation with the tissue Doppler imaging usage, the study of the renal vessels blood flow and uterine-placental hemodynamics. Mild asthma course was observed in 41 (62.1%) patients, moderate - in 20 (30.3%) and severe - in 5 (7.6%). During the estimation of the left heart diastolic function in pregnant women with asthma, the flow rate of early diastolic filling - Em and the ratio of Em/Am were lower than in healthy individuals (p <0.05), which indicates a violation of relaxation processes due to increased myocardium rigidity. In ultrasound diagnosis of utero-placental hemodynamics changes, there was revealed a difference in the state of vascular resistance in the uterine artery pool in the period of 20-24 weeks of gestation. The intensity of blood flow was lower in the asthma patients groups, which was expressed in an increase in the values of the resistance index. The majority of patients experienced the development of gestational complications. Among the diseases of newborns from mothers with asthma the most frequent were: cerebral ischemia, intrauterine infection, adaptation period violation, intrauterine growth restriction, motor disorders syndrome.